Nutritional risk, hospitalization and mortality among community-dwelling Canadians aged 65 or older.

BACKGROUND Nutritional risk has been associated with various negative health outcomes among older people. Limited longitudinal research has examined the relationship between nutritional risk and hospitalization and death in community-dwelling older people. DATA AND METHODS Data from the 2008/2009 Canadian Community Health Survey-Healthy Aging (CCHS-HA) linked to the Discharge Abstract Database and the Canadian Mortality Database were used to estimate the prevalence of nutritional risk among seniors and examine its relationship with acute care hospitalization and death during the 25- to 36-month period following the CCHS-HA interview. Multivariate Cox proportional hazards models were used to identify important covariates, while adjusting for demographic and socioeconomic characteristics, health status, and lifestyle factors. RESULTS A third (34%; 979,000) of Canadians aged 65 or older living in 9 provinces (excluding Quebec) were at nutritional risk in 2008/2009. These seniors had a higher risk of an acute care hospitalization (hazard ratio (HR) 1.2; 95% CI: 1.1 to 1.4) or death (HR 1.6; 95% CI: 1.3 to 2.0) during the follow-up period, even when potential confounders were taken into account. Seniors at nutritional risk in 2008/2009 were more likely than those not at nutritional risk to die during follow-up (9% versus 5%) and averaged shorter survival times: 498 days (95% CI: 462 to 534) compared with 538 days (95% CI: 501 to 574). INTERPRETATION Based on an analysis of data from a large population-based survey linked to routinely collected hospital and death data, nutritional risk is independently associated with acute care hospitalization and mortality. Results highlight the importance of monitoring seniors for nutritional risk.